Podcasts

Episode 37: COVID- Isolation Facilities and Alternate Care Sites

What happens when we reach surge capacity at the hospitals? Where do patients go if they don’t have a home where they can safely quarantine? What about our nursing home patients? In this episode, we detail the plans for all of these patients.
Podcasts

Episode 36- COVID: What about my ACE inhibitors

SUPER short one today about COVID and ACE inhibitors (-pril) and Angiotenstin Receptors Antagonists, like Angio Recept Antag. Maybe ang rec ant. Or artan. Artans yeah, that’s it.

Podcasts

Episode 35- COVID: New therapies, and can I use ibuprofen?

We talk about some of the things you’ve seen in the news lately about treatments that might help COVID. AND WHAT DO THEY MEAN I CAN’T TAKE IBUPROFEN? *sad Army Doc noises*

Podcasts

Episode 34: COVID-19, part 2. When can I go back to work?

I hate you.

So, you caught the COVID. You have endured the fever, cough, sore throat, diarrhea, and abject boredom of being home. When can you be let out of this prison? In this micro episode we talk about the return to work criteria. BLUF: No, you don’t have to be in quarantine forever.

Podcasts

Episode 33: COVID-19, Part 1

This little jerk right here.

Covid is now a pandemic, the real kind, the not-the-zombie-kind. In this episode we talk about what the Office of the Medical Director, Austin Public Health, and Austin/Travis County EMS is doing to respond to what is now a declared disaster.

Podcasts

Ep 32: Talking with the Union Prez

Buy in from the workforce is necessary to bring any useful change to an organization. While unions and leadership are often set against each other, the things they can accomplish when they work together far exceed those they can accomplish when moving in different directions. The union can give the MD valuable feedback on wants and barriers to implementation, and the MD can get an idea of how to effectively introduce change to the department with wide support. I’m fortunate to get to work with Selena Xie, who is smart, politically savvy, collaborative, and has an eye for the immediate future and years down the line.

selena x

Podcasts

Episode 31: Headache

Some causes of headache are benign, but the EMS provider would be wise to consider carefully some “bad actors” that cause headache. Here we will talk too about how to manage these patients in the prehospital setting.

woman working girl sitting
Photo by Alexander Dummer on Pexels.com

Podcasts

Episode 30: Meditation and mindfulness for the first responder with Jessica Sasser, RN

Jessica Sasser, RN, is one of the amazing staff at our public safety wellness division which supports the physical and mental health of Austin/Travis County EMS and Austin Fire Department. In this episode she discusses meditation and how it can be useful to the first responder. Hint: it doesn’t just make you feel better, it makes you better. Please don’t meditate while driving.

Resources for ATCEMS and AFD employees can be found at: atxpublicsafetywellness.com

Insight Timer can be downloaded from the Apple app store.

Podcasts

Episode 29: Medic to PA to MD

Combat medic, paramedic, PA, and now medical student Andy Fisher talks about his journey. If you’ve thought about making the leap from #EMS, don’t miss this episode.

Podcasts

Episode 28: Andy Fisher talks BLOOD

In patients with hemorrhage, nothing else can take the place of #blood. Andy Fisher talks about why, and how, you can bring #blood to your #EMS system.

Podcasts

Episode 27: Syncope

Syncope, or fainting, is an incredibly common complaint seen by #EMS providers. This short episode discusses some of the exam findings and considerations.

The Epsilon wave: https://litfl.com/epsilon-wave-ecg-library/

Wolff Parkinson White syndrome: https://www.youtube.com/watch?v=K098rnvqRE0

Lown Ganong Levine syndrome: https://ecglibrary.com/lgl.html

Podcasts

Episode 26: EtCO2

If you are not using #EtCO2 during airway management and monitoring, then you are wrong. Fix yourself. Dr. Pickett tells you why. #EMS #Prehospital #Paramedic #maybeifIsqueezethisbagashardandfastasIcanthepatientwillgetbetter #morewavylines #butIjustlearnedEKGs #Isawthetubegothroughthecords #sodideveryonewhoevermisplacedanETtube

Podcasts

Episode 25: Tracheostomy Disasters

Do you get nervous when you are faced with a patient with a tracheostomy tube? This short episode covers common problems and how to troubleshoot them. Be nervous no more.  #paramedic #EMS #prehospital #criticalcare

In this episode, I make reference to a couple of great YouTube videos on the subject. One is from RT Clinic on the ins and outs of tracheostomy devices. The other is from The Crashing Patient Series from the University of Maryland and goes into greater depth on care of the crashing tracheostomy patient.

Podcasts

Episode 24: New Clinical Operating Guidelines

We undertook the unenviable task of revising our clinical operating guidelines to make them more usable, more manageable, and easier to read. We want to foster a clinician mindset and embrace the clinical flexibility medics need to take care of our patients in a very fluid environment. We also created new credentialing levels for medics to expand their current horizons.

Podcasts

Episode 23: Flight Rules

Today we are covering some of the flight rules for those studying for their #FP-C exam.  #paramedic #EMS #prehospital #HEMS

Podcasts

Episode 22: Flight Physiology, Part 3/3

Today we are covering a bit of #flight physiology for those studying for their #FP-C exam. We broke this episode into 3 parts to make it a bit more manageable. #paramedic #EMS #prehospital #HEMS

Podcasts

Episode 21: Flight Physiology, Part 2/3

Today we are covering a bit of #flight physiology for those studying for their #FP-C exam. We broke this episode into 3 parts to make it a bit more manageable. #paramedic #EMS #prehospital #HEMS

Podcasts

Episode 20: Flight Physiology Part 1/3

Today we are covering a bit of #flight physiology for those studying for their #FP-C exam. We broke this episode into 3 parts to make it a bit more manageable. #paramedic #EMS #prehospital #HEMS

Podcasts

Episode 19: Heat illness

Heat illness ranges from the benign and temporary to the life-threatening. We dive into management of heat cramps, heat syncope, heat exhaustion, and heat stroke. Rule #1: Stay on scene to cool them down.

 

Podcasts

Episode 18: Trauma reports

In person and on the radio, make the most of your concise patient report.  

Podcasts

Episode 17: The monitor should stay on.

If you felt the need to put a #cardiac monitor on at any point in the patient interaction, it should stay on as you walk into the ED. #EMS #paramedic #prehospital

Podcasts

Episode 16: Airway Pearls

We dug into our QA data and the literature to bring you some pearls on #prehospital #airway management. #EMS #paramedic

Podcasts

Episode 15: Sepsis

750,000 Americans will suffer from sepsis this year. Early recognition and treatment are key. Here we go into the field recognition of sepsis and treatment priorities.

Podcasts

Stroke treatment 24 hours from onset

For patients with #stroke outside of 4.5 hr #tPA window, they may benefit from thrombectomy up to 24 hours since last seen well. Take to comprehensive stroke center and perform MRI safety screen. #EMS #paramedic

https://www.emsworld.com/news/220085/new-24-hour-window-stroke-treatment-proving-successful-some-patients

Podcasts

‪Quick and dirty estimation of weight for #pediatric #resuscitation

Quick and dirty estimation of weight for #pediatric #resuscitation:

Birth: 5kg.

Age 1: 10kg.

Age 3: 15kg.

Age 5: 20kg.

Age 7: 25kg.

Age 9: 30kg.

#PALS #APLS

Podcasts

Episode 14- Fast facts for response to bombing victims

This is a short episode on the response to and care for bombing victims for #EMS, #Firedepartement and #Police. A longer episode will follow that covers #prehospital care in detail, but this is the initial response and considerations. #packagebombmurders #austinbombings @ATCEMS @Austin_police @austinfiredepartment @TxDPS @TravisCoSheriff @CommitteeTECC @CommitteeonTCCC @NTOATEMS Find us on @iTunes and @GooglePlay and @feedburner

Podcasts

Safe evacuation distances from explosives

From the National #Counterterrorism Center, this chart gives #evacuation distances for #explosives of different sizes. Time, distance, shielding. Minimize the TIME you are in a threat zone, increase DISTANCE between you and the device, and seek SHIELDING in the form of cover from hard buildings or terrain. #packagebombmurders #austinbombings #EMS #prehospital #paramedic #firedepartment

https://www.dni.gov/files/NCTC/documents/features_documents/2006_calendar_bomb_stand_chart.pdf

Podcasts

Episode 13: Cannabis Hyperemesis Syndrome

Neither rare nor mysterious, Cannabis Hyperemesis Syndrome causes pain and vomiting that can be difficult to treat.

Marijuana use is growing for medical purposes and recreational abuse. With this has come a rise in Cannabis Hyperemesis Syndrome which is marked by recurrent, severe abdominal pain and vomiting that does not respond well to the usual antiemetics. Dr. Pickett discusses the causes and treatment of this disorder which we will recognize in increasing numbers with increased marijuana availability.

Podcasts

Critical care inter facility transport: Handling conflict with class and style

Dr. Cynthia Griffin @CMGrffn wrote this great article on #CCT and how to handle orders that conflict with protocol or practice style. Doctor’s orders and intra-transfer modifications

#EMS #paramedic #flightmedic #flightnurse

Podcasts

Episode 12: Trauma Resuscitation

Fluid resuscitation, blood, acidosis, coagulopathy, hypothermia, TXA, intubation, push dose pressors! All the greatest trauma lit for your naughty bits.

Podcasts

SVT with aberrancy, or V-tach?

Some tips to help differentiate #SVT with aberrancy and #vtach. #EMS #prehospital #paramedic

https://www.aliem.com/2013/07/supraventricular-tachycardia-svt-with-aberrancy-versus-ventricular-tachycardia-vt/

Podcasts

Episode 11: MRI for acute stroke- screening in the field

In this episode we sat down with Dr. Steven Warach the Director of the Clinical Research Institute and Vascular Neurologist from Dell Seton Medical Center to talk about acute MRI for stroke and how we might be able to reduce the time to treatment.

3 questions comprise the safety screen:

  1. Do you have any implanted electronics like a pacemaker or defibrillator?
  2. Do you have any vascular clips in your brain?
  3. Do you have any metal fragments in your body?

Podcasts

Episode 10: Asthma!

Most asthma is pretty routine. Most. Dr. Pickett talks about tools for management of the severe asthmatic adult or child.

 

Podcasts

Episode 9: Bedside Teaching- Medic Mindset and ATCOMD joint podcast! Teaching at the bedside in the field or in the hospital.

Some people have the natural gift of teaching. For others it does not come easily. Teaching is all about connecting with your student, finding out their abilities and weaknesses, and helping build them into stronger clinicians. Teaching is a learned skill that can be molded and honed no matter how good a teacher you are. I sat down with Ginger Locke, Associate Professor of EMS Education at Austin Community College and the producer of the Medic Mindset podcast to see what tips and tricks we can offer the field preceptor.

Basic RGB

Podcasts

ATCEMS OMD Podcast Episode 8: Atrial fibrillation!

Ever had that patient that you just weren’t sure what pathway they fit in?

You have a 75 yo F who called 911 due to palpitations and increasing shortness of breath. She looks fairly comfortable with belies the rate of 180 seen on the monitor. She does endorse some chest discomfort. No previous drug use, no recent surgery/ Rhythm might be irregular but it’s too hard to tell at that rate. Should I cardiovert? Should I give them diltiazem? Could this tachycardia be reactive to something, and I should look for other potential issues?

Podcasts

Reconstruction of the Vegas shooting

NYT reconstruction of Vegas shooting

This is a very well done reconstruction of the mass shooting in Las Vegas. Several things to note here: varying reactions in the crowd (you can see some individuals standing and staring in disbelief as others run to cover), care under fire and members of the crowd organizing others to help, and the police who charged into the gunfire to end the shooting.

Podcasts

ATCEMS OMD Podcast Episode 7: Mishmash! Dextrose, hemostatic agents, and chest seals.

Decided to address some reader comments with this one. Dextrose, hemostatic agents, chest seals. Little bit of medicine, little bit of trauma.

Why did we change over from D50 to D10 for hypoglycemia? And should we be treating hypoglycemic diabetics the same way we did 30 years ago? Should I have a hemostatic gauze in my kit? And how useful are chest seals really?

Podcasts

ATCEMS OMD Podcast Episode 6: Flush rate oxygen, apneic oxygenation, and ramped positioning for intubation

Do you like it when your patient desaturates just as you are getting ready to intubate them? Of course not, nobody does. Here are some tricks to help keep the sat up while you secure the airway.